Objective To investigate the epidemiological characteristics and influencing factors of Femoral Artery Compression-Related Skin Complications Around the Puncture Site(FACR-SCAPS)in patients with primary hepatocellular carcinoma(HCC)undergoing transarterial chemoembolization(TACE).Methods A multicenter cross-sectional study was conducted using convenience sampling.A total of 1 573 HCC patients who underwent TACE between April 2023 and October 2024 were recruited from interventional radiology departments,oncology units,and specialized centers across 10 hospitals in Beijing,Tianjin,Shandong,Hebei,Qinghai,and Inner Mongolia.Descriptive statistics,univariate analysis,and multivariate logistic regression were used to explore the epidemiological characteristics and influencing factors of FACR-SCAPS in this population.Results Among the 1 573 primary HCC patients undergoing TACE interventional therapy,FACR-SCAPS occurred in 28.99％(456/1 573),with a total of 476 complication instances recorded(30.26 per 100 patients).Patients with a single complication accounted for 96.93％,whereas those with multiple complications constituted 3.07％.The most prevalent types of complications were skin erythema,skin ecchymosis,and hard lumps formation,collectively accounting for 96.49％of all complications.Hematoma,blisters,and rupture complications collectively accounted for only 4.61％.Logistic regression analysis revealed that peak diastolic blood pressure during compression(OR=1.024,95％CI:1.013-1.035,P＜0.001),use of rotary compression hemostasis devices(OR=3.220,95％CI:2.120-4.891,P＜0.001),elevated PT-INR(OR=19.630,95％CI:6.039-63.810,P＜0.001),and anticoagulant use within the last three months(OR=1.909,95％CI:1.064-3.427,P=0.030)were significant influencing factors associated with FACR-SCAPS post-TACE.Conclusion FACR-SCAPS is commonly seen among primary HCC patients after TACE,its risk factors include peak diastolic blood pressure during compression,use of rotary compression devices,elevated PT-INR,and recent anticoagulant use.

Objective To explore the impact of"knowledge-attitude-practice"(KAP)training mode on head nur-ses' core competency in healthcare-associated infection(HAI)prevention and control in a tertiary first-class general hospital.Methods Head nurses of 113 departments in a tertiary first-class general hospital were taken as the re-search objects.Guided by problems and demands,HAI training was conducted using the KAP training mode.The training was divided into two stages:a stage with problems of infection control and investigation of knowledge de-mands,as well as a stage with KAP training mode implementation.It included theoretical lectures,visits and lear-ning,and supervision on rectification.Scores of theory,supervision,and core competency of head nurses before training,1 month and 6 months after training were compared by the analysis of variance.SPSS 26.0 statistical soft-ware was used for analysis.Results The top three infection control problems in this hospital were hand hygiene,prevention and control of infection with multidrug-resistant organisms,as well as HAI prevention and control in the wards.The top three training modules required urgently by the head nurses were occupational exposure and self-protection,principles of medical waste disposal,as well as prevention and control of HAI in the wards.Both scores of theory and supervision after training were higher than those before training,with statistically significant diffe-rences(both P＜0.01).The core competencies of the head nurses were at a high level.After implementing KAP training mode,the scores of dimensions in critical thought and research,clinical nursing,leadership,and profe-ssional development,as well as the overall score of core competencies were all higher than before training.Diffe-rences were all statistically significant(all P＜0.05).The overall scores of dimensions in legal and ethical practice,education and consultation,as well as interpersonal relationship were all higher than before training,but the diffe-rences were not statistically significant(all P＞0.05).Conclusion KAP training mode can significantly improve the scores of theory,supervision,and core competencies of head nurses,and can be further promoted and applied in head nurses' infection control training.

Objective:To explore the impact of a three-dimensional management based on a perinatal one-day clinic on pregnancy outcomes in overweight and obese pregnant women.Methods:It was a randomized controlled trial. A simple random sampling method was used to select 460 singleton pregnant women with a pre-pregnancy body mass index≥24 kg/m2 who had regular prenatal check-ups at the Obstetrics and Gynecology Center of the Third Affiliated Hospital of Chongqing Medical University from June 1, 2018, to December 31, 2022. The women were randomly divided into an experimental group and a control group (230 cases each) using a computer-generated random number table. The control group received regular prenatal check-ups according to the pregnancy care guidelines (once every 4 weeks during mid-pregnancy, once every 2 weeks during late pregnancy, with additional frequency as needed based on the condition). The control group also received a one-time body composition analysis and dietary guidance from a nutritionist at the time of registration. In addition to the control group′s interventions, the experimental group received three-dimensional management based on a perinatal one-day clinic. It included an intensive one-day clinic session, a traditional plus internet-based re-education model (as needed based on the condition), individualized guidance from obstetrics and clinical nutrition clinics (once every 2 weeks), a free body composition test at 24 weeks of pregnancy, and weekly WeChat group push of health care knowledge during pregnancy. A total of 55 cases dropped out, leaving 200 cases in the experimental group and 205 cases in the control group for analysis. General information, pregnancy-related, and postpartum indicators were collected in the two groups. The effect of three-dimensional management based on a perinatal one-day clinic on pregnancy outcomes in overweight and obese pregnant women was analyzed using t-tests and chi-square tests. Results:There was no significant differences in baseline age, pre-pregnancy body mass index, initial blood glucose, initial glycated hemoglobin, or initial gestational age between the two groups (all P>0.05). The experimental group showed significantly lower gestational weight gain, neonatal weight, and proportion of excessive pregnancy weight gain compared to those in the control group [(11.41±5.23) vs (13.22±4.51) kg, (3 352.1±465.3) vs (3 489.5±464.0) g, 48.00% vs 73.17%] (all P<0.05). There were no significant differences in hospitalization days, gestational age at delivery, incidence of gestational diabetes, incidence of hypertensive disorders of pregnancy, incidence of premature rupture of membranes, incidence of preterm birth, incidence of macrosomia, vaginal delivery rate and rate of neonatal transfer to the pediatric department between the two groups (all P>0.05). Conclusion:Early intervention with the three-dimensional management based on the one-day perinatal clinic can effectively control gestational weight gain and neonatal weight in overweight and obese pregnant women.

Objective To investigate the potential value of a deep learning(DL)model based on non-contrast CT images in predicting contrast medium extravasation in contrast-enhanced CT scans of tumor patients.Methods A total of 298 tumor patients were retrospectively selected,including 90 patients with extravasation and 208 without extravasation,and divided into training set(207 patients),validation set(46 patients),and external test set(45 patients)in a ratio of 7︰1.5︰1.5.U-Net was employed to segment the right common carotid artery/internal jugular vein and right subclavian artery/vein in non-contrast CT images,and ResNet50 was utilized to extract imaging features to construct the DL model,which was subsequently integrated with independent clinical predictors to establish the combined model.The segmentation performance of the DL model was evaluated using Dice similarity coefficient(DSC)and Intersection over Union(IoU),while the area under the curve(AUC),accuracy,sensitivity,and specificity of the model were calculated.Results The DL model demonstrated superior vascular segmentation(DSC 0.81-0.95,IoU 0.79-0.90).The combined model achieved optimal predictive performance,with AUC of 0.961[95%confidence interval(CI)0.924-0.983],0.949(95%CI 0.840-0.992),and 0.891(95%CI 0.762-0.964)in the training,validation,and external test sets,respectively.Its accuracy,sensitivity,and specificity were consistently higher than those of the standalone clinical model.Conclusion The DL model based on non-contrast CT images shows significant potential value in predicting contrast medium extravasation risk in tumor patients,providing an objective and intelligent tool for clinical risk assessment.

Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health, function, and aesthetics, ensuring both patient satisfaction and long-term stability. Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues, especially in severe cases. Therefore, close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment, along with diligent patient compliance throughout the entire process, is crucial for achieving favorable treatment outcomes. Moreover, long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success. This expert consensus, informed by the latest clinical research and practical experience, addresses clinical considerations for orthodontic treatment of periodontal patients, delineating indications, objectives, procedures, and principles with the aim of providing clear and practical guidance for clinical practitioners.
Humans ; Consensus ; Orthodontics, Corrective/standards* ; Periodontal Diseases/complications* ; Tooth Movement Techniques/methods* ; Practice Guidelines as Topic

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

OBJECTIVE To explore the clinical distribution and drug resistance of common species of pathogens iso-lated from a three-A hospital of Guangzhou from Jan.2017 to 2023 Dec.so as to provide bases for clinical diagno-sis and reasonable use of antibiotics.METHODS A total of 10,086 strains of aerobic bacteria were clinically isola-ted from the patients who were hospitalized in a three-A hospital of Guangzhou from 2017 to 2023.The constituent ratios of the common species of pathogens,specimen sources,distribution of departments and drug resistance rates to commonly used antibiotics were retrospectively analyzed.RESULTS Totally 10,086 strains of pathogens were isolated from the specimens of the hospitalized patients from 2017 to 2023.Klebsiella pneumoniae,Pseudo-monas aeruginosa,Escherichia coli,Acinetobacter baumannii and Staphylococcus aureus ranked the top 5 species of pathogens.The sputum,midstream urine and whole blood were the major specimen sources.The hospital-asso-ciated infection was highly prevalent in critical care medicine department,neurology department,geriatrics depart-ment,neurosurgery department and urology department.The result of drug resistance showed that the drug re-sistance rates of the K.pneumoniae and P.aeruginosa strains to various types of antibiotics showed upward trends(P＜0.05);the drug resistance rate of the A.baumannii strains to imipenem was decreased,while the drug resist-ance rates to most of the antibiotics were more than 45％.No gram-positive cocci strains that were resistant to vancomycin,teicoplanin or linezolid were found.CONCLUSIONS The common clinical isolates of pathogens are generally resistant to antibiotics.It is necessary for clinicians to attach great importance to the culture of pathogens and drug susceptibility testing and reasonably use antibiotics based on the result of drug susceptibility testing so as to reduce the occurrence and spread of drug-resistant strains.The hospital should strengthen the surveillance of drug resistance of bacteria so as to boost the clinical curative effect,standardize the management and use of antibi-otics and take effective measures to control of the hospital-associated infection.

OBJECTIVE To analyze the status of targeted monitoring of the health care-associated infections in in-tensive care unit(ICU)of a three-A hospital of northwest China in recent 7 years so as to provide bases for formu-lating effective prevention and control measures for the health care-associated infections.METHODS The related data were successively collected from the ICU hospitalized patients of the Second Affiliated Hospital of Air Force Medical University who were under the targeted monitoring by nosocomial infection real-time monitoring system from Jan.2017 to Dec.2023.The data included the incidence of infections,infection sites,use of catheters,inci-dence of catheter-related infections,and distribution and prevalence trend of pathogens.RESULTS A total of 49,137 hospitalized patients from five ICU wards of respiratory medicine department,neurosurgery department,neurology department,thoracic surgery department and critical care medicine department were under the monito-ring,1446(1681 case-times)of whom had health care-associated infections,with the infection rate 2.94％,the case-time infection rate 3.42％.The respiratory system was the major infection site of the patients with the health care-associated infections.Among the patients with instrument-associated infections,20.70％had ventilator-asso-ciated pneumonia(VAP),5.71％had urinary catheter-associated urinary tract infection(CAUTI),and 1.96％had catheter-related bloodstream infection(CRBSI).Totally 405 strains of non-repetitive pathogens were isolated from 477 patients with instruments-associated infections,78.77％of which were gram-negative bacteria.The iso-lation rate of multidrug-resistant organisms(MDROs)was 44.12％,and Acinetobacter baumannii was the pre-dominant species of pathogen isolated from the patients with VAP.CONCLUSIONS The targeted monitoring of health care-associated infections may facilitate the awareness of dynamic changes of the infections in a accurate and timely manner so as to provide bases for developing effective prevention and control measures for the health care-associated infection.It is necessary to strengthen the prevention and control of the infections in critical care medi-cine department,neurosurgery department as well as the lower respiratory tract infections and prevent the MDROs infection in the meantime.

Objective:To explore the current status and trends in emergency nursing teaching methods based on CiteSpace software in China from 2012 to 2023, and to provide reference for subsequent research.Methods:Literature on teaching methods in emergency nursing was electronically searched in the China National Knowledge Infrastructure, WanFang Data, and VIP from January 2012 to December 2023. CiteSpace and Excel software were used to perform bibliometric analysis on the publication year, journal source, first author affiliation, keywords and clustering content.Results:An initial search yielded 1 550 articles and 936 relevant articles were screened and published in 194 journals. From 2012 to 2023, the number of publications on teaching methods in emergency nursing in China was relatively flat, the first author affiliations were mainly general hospitals, and the research methods were mainly quantitative. Keyword clustering showed that six themes were extracted, including exploration of professional skills, reform and application of teaching methods, nursing teaching and evaluation, teaching modes, teaching tools, and training modes.Conclusions:The trend of publications in emergency nursing teaching methods in China in the past 10 years has been relatively flat, and the quality of the literature needs to be improved. Emergency nursing teaching needs to focus on reforming teaching modes and methods, and further exploring the use of tools such as mind maps and teaching manuals to improve the quality of teaching.

OBJECTIVE To explore the clinical distribution and drug resistance of common species of pathogens iso-lated from a three-A hospital of Guangzhou from Jan.2017 to 2023 Dec.so as to provide bases for clinical diagno-sis and reasonable use of antibiotics.METHODS A total of 10,086 strains of aerobic bacteria were clinically isola-ted from the patients who were hospitalized in a three-A hospital of Guangzhou from 2017 to 2023.The constituent ratios of the common species of pathogens,specimen sources,distribution of departments and drug resistance rates to commonly used antibiotics were retrospectively analyzed.RESULTS Totally 10,086 strains of pathogens were isolated from the specimens of the hospitalized patients from 2017 to 2023.Klebsiella pneumoniae,Pseudo-monas aeruginosa,Escherichia coli,Acinetobacter baumannii and Staphylococcus aureus ranked the top 5 species of pathogens.The sputum,midstream urine and whole blood were the major specimen sources.The hospital-asso-ciated infection was highly prevalent in critical care medicine department,neurology department,geriatrics depart-ment,neurosurgery department and urology department.The result of drug resistance showed that the drug re-sistance rates of the K.pneumoniae and P.aeruginosa strains to various types of antibiotics showed upward trends(P＜0.05);the drug resistance rate of the A.baumannii strains to imipenem was decreased,while the drug resist-ance rates to most of the antibiotics were more than 45％.No gram-positive cocci strains that were resistant to vancomycin,teicoplanin or linezolid were found.CONCLUSIONS The common clinical isolates of pathogens are generally resistant to antibiotics.It is necessary for clinicians to attach great importance to the culture of pathogens and drug susceptibility testing and reasonably use antibiotics based on the result of drug susceptibility testing so as to reduce the occurrence and spread of drug-resistant strains.The hospital should strengthen the surveillance of drug resistance of bacteria so as to boost the clinical curative effect,standardize the management and use of antibi-otics and take effective measures to control of the hospital-associated infection.